Providing answers to common questions we hear from our peers in primary care, as well as the signs and symptoms that may indicate the need for a neurology evaluation.
Primary Steps for Primary Care: Microcephaly (10/21/2020) - Central to a newborn examination is the tracking of growth parameters; head circumference is a key component in that evaluation. Identification of an abnormal head circumference, especially in the context of developmental delays, warrants evaluation by a neurologist and possibly a geneticist. Though it’s a frequently encountered exam finding, microcephaly is a poorly defined condition with a myriad of causes and lack of uniform… … Continue reading Primary Steps for Primary Care: Microcephaly
Infantile Spasms – Primary Steps for Primary Care (12/4/2019) - A type of severe seizure, infantile spasms require urgent evaluation and treatment. Unfortunately, the diagnosis of infantile spasms is too often delayed because they may be subtle, go unrecognized, or be misdiagnosed as some other less serious condition (i.e., reflux). When associated with an electroencephalography (EEG) pattern of hypsarrhythmia (Figure 1), this is known as West syndrome, a severe form of early onset/infantile epilepsy.… … Continue reading Infantile Spasms – Primary Steps for Primary Care
Torticollis – Primary Steps for Primary Care (10/16/2019) - Torticollis is characterized by a lateral head tilt with the chin rotated in the opposite direction. It can be caused by many conditions, most commonly as a result of congenital asymmetry in the lengths of the sternocleidomastoid (SCM) muscles. Torticollis occurs in approximately 0.3-1.9% of all live births, more frequently in males, and most commonly on the right side. While etiology is unknown, multiple… … Continue reading Torticollis – Primary Steps for Primary Care
Transitioning to Adult Neurology Care (1/9/2019) - While “Primary Steps” articles are often written for primary care providers, some subjects are equally valuable to patients, their families and their speciality providers. Moving from a pediatric care provider to an adult care provider is likely to be very challenging for many patients – particularly those with special needs. Youth with neurologic conditions and their families often feel discouraged to work on long-term… … Continue reading Transitioning to Adult Neurology Care
Staring Spells – Primary Steps for Primary Care (11/6/2018) - Staring spells is a common chief complaint in pediatrics often noted by parents or teachers prompting evaluation. While absence seizures are certainly on the differential, staring can be many other things and careful history and evaluation is needed to guide evaluation and management. What is the differential of staring spells? Often times staring events in children represent transient inattention or daydreaming where the child… … Continue reading Staring Spells – Primary Steps for Primary Care
Headaches – Primary Steps for Primary Care (10/31/2018) - The start of the school year is just around the corner, and we frequently see an increase in calls regarding headaches around this time. We want to take this opportunity to review some basic steps in diagnosing and treating headaches. Nearly 10 percent of children have frequent or recurrent headaches. While this is a significant source of parental anxiety, the vast majority are benign… … Continue reading Headaches – Primary Steps for Primary Care
Tics – Primary Steps for Primary Care (10/31/2018) - Tics are repetitive, stereotyped, involuntary movements that usually begin in childhood. They can consist of motor and vocal tics, such as excessive eye blinking/rolling, facial grimacing, neck or shoulder jerks, sniffing, throat clearing or other vocalizations. Tics can be transient or chronic. If chronic, it may meet the criteria for Tourette syndrome. Tourette syndrome is defined as multiple motor and vocal tics that have… … Continue reading Tics – Primary Steps for Primary Care
Concussion – Primary Steps for Primary Care (10/8/2018) - A concussion is a trauma-related pathophysiological process that affects the neurometabolic function of the brain. Concussions are quite prevalent; the CDC reports 3.8 million sport-related brain injuries occur annually. It is estimated in middle school and high school children, up to 20% of children have suffered a concussion. In the majority of patients, post-concussive symptoms resolve within 10 days. By 1 month, 72% of… … Continue reading Concussion – Primary Steps for Primary Care